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Finding the Right Daycare or Preschool for Your Food-allergic Child
Because food allergies have become more common, some preschools and daycares already have experience working with food allergic children.
However, if you find a center that has never dealt with food allergies before, make sure they are willing to work with you and learn what needs to be done to keep your child safe. Following are tips to keep in mind when evaluating potential caregivers for your child.
Visit the daycare or preschool to evaluate its appropriateness for you child. As you talk to the staff, try to get a sense of their compassion and competence for your child's situation. If they appear reluctant to learn about or manage your child's food allergies, then you'll want to keep looking. Sometimes you may have to pass up the "best" center in terms of academics or convenience if you have doubts that it might not be the safest for your child. Safety is the priority.
During your visit, be sure to ask a lot of questions. Examples include have they had any formal training on food allergies? Are they familiar with injectable epinephrine, like EpiPen® or Auvi-Q®, and if not, would they be willing to learn? Are they aware that each child's sensitivity may vary and that what works for one child may not work for yours? Are they willing to consider working with other parents to make sure only safe foods are brought in or possibly becoming, for example, peanut-free for the safety of your child? Think of ways you can make the situation easier, such as sharing training materials on food allergies with school staff, offering to provide safe snacks for your child's class, or signing up as a classroom volunteer to ensure a smooth transition.
One of the most important things you can do to protect your child is to create a written action plan before the child starts attending the school or daycare. The action plan should contain two parts: an emergency plan outlined by your child's physician, and a plan describing how the staff will manage the environment on a daily basis. Discuss this with your child's teacher, the school director, and other key staff.
The emergency plan from your physician should detail medication, dosages, and treatment that should be used in the event of a reaction. This part of the plan should also outline the signs of an allergic reaction and necessary steps to take. The Food Allergy Action Plan is a tool for this. Be sure to provide the center with plenty of medication such as antihistamine and autoinjectors of epinephrine that should be kept in an unlocked cabinet out of reach of children but accessible to adults.
The second part should outline how the staff will handle daily avoidance of allergen exposure in the class environment. Make sure they are willing to have all staff trained on recognizing a reaction and administering epinephrine.
Develop an allergy management plan
When you work with the preschool or daycare to develop an allergy management plan, the following are examples of important issues to address:
Other things to consider include rules about your child using the water fountains (bottled water may be a safer alternative) or accepting classroom treats. For special events that occur, a safe treat box, provided by you, will give your child safe food to enjoy while the other children are having treats. If possible, volunteering or chaperoning for special events, parties or field trips can help ensure your child's safety.
To ensure buy-in and commitment to the child's plan, try to work in partnership with the school to develop a plan that's realistic while ensuring your child's safety. Also, consider getting your child a medical identification bracelet for easy identification and as a constant reminder to staff about your child's allergies.
If a daycare or preschool is unwilling to take on the responsibility for your child's medical needs at school, know that the Americans with Disabilities Act (ADA) specifies that children with severe, life-threatening allergies cannot be denied admission to a daycare program because of their allergies, and that a child care center is required by Title II or Title III of the ADA to administer medication for an allergic reaction. There is, however, an exception for religious preschools or daycares.
Other helpful information for you and your child's daycare or preschool can be found from Kids With Food Allergies Resources and the Food Allergy Research and Education. If you'd like to compare notes with other parents as you prepare your own child to attend preschool or daycare, be sure to check out the support forums offered by Kids With Food Allergies. There is a dedicated support forum for parents of babies, toddlers and preschoolers; as well as a forum for parents of school-aged children.
Updated August 2008, 2013. This article first appeared in the Fall 2007 edition of Support Net™ and is available to download (requires Adobe Reader .)
Approved by KFA Medical Advisory Team August 2007. Links revised May 2013.